In this 2015 photo, Bhagwati Chauhan, who had recently given birth to a Canadian couple’s child, touches the 9-month pregnant belly of Makwana, who was carrying twins for an American couple, at the Akanksha Clinic in Anand, India. Chauhan’s husband had died recently and she needed the money from surrogacy in order to buy a home and send her son to school. (AP Photo/Allison Joyce)
Surrogacy occurs when a woman, the surrogate mother, bears a child for another couple due to that couple’s inability to bear children (“Surrogate Motherhood”). Two types of surrogacy exist currently. Traditional surrogacy consists of the surrogate mother being artificially inseminated with the sperm of either a donor or the intended father. This type of surrogacy results in the child being the surrogate mother’s genetic offspring. The most common type of surrogacy today is gestational surrogacy through in vitro fertilization, in which an embryo produced with another woman’s ovum is implanted in the surrogate. This type of surrogacy has become more popular in order to avoid the genetic link between surrogate mother and child and to provide a genetic link between the child and both parents hiring the surrogate (O’Reilly 1184).
Surrogacy started to become a viable option for infertile families in the mid-1970s as embryotic technology was improving and the number of children available for adoption was decreasing (“Surrogate Motherhood”). The first formal contract between a surrogate and a couple seeking a child was signed in 1976 in the United States, yet surrogacy did not draw much attention until the Baby M court case in 1986-1988. In this legal battle, Mary Beth Whitehead, the surrogate, was artificially inseminated as a result of a contract between her and an affluent New Jersey couple. After giving birth to a baby girl, Whitehead refused to give her to the couple. Initially, a judge ruled in favor of the couple by upholding the contractual arrangement. The New Jersey Supreme Court then overturned this ruling, saying the contract constituted “baby selling” (O’Reilly 1185). Commercial surrogacy was then banned in New Jersey and it was declared that any woman acting as a surrogate has the right to change her mind and keep the child. As a result, many US states and most European countries have since banned commercial surrogacy (O’Reilly 1185). California, for example, is one of the few states that still allows commercial surrogacy while a state like New York does not recognize any surrogacy agreements (Markens 7). In Europe, surrogacy is banned in France, Germany, Italy, and Spain while Belgium and the Netherlands only ban commercial surrogacy (Deomampo 223).
Surrogacy has developed primarily due to wealthy women’s infertility and a desire to have a genetic link between the infertile couple and the child (Freidenfelds). Surrogacy is expensive so it is not a viable option for poorer families and young couples just beginning their careers. In the United States, for example, surrogacy generally costs between $50,000 to $100,000, making it significantly more expensive than any other use of technology to combat infertility (“Infertility Treatments”). In recent years, there has been a trend for women to have children later. According to the CDC, birth rates for women their early 20s in 2015 were at a record low while birth rates for women in their 30s are the highest they have been since 1962, with rates in women ages 35-39 increasing the most significantly (Martin 4). This data also displayed that rates of fertility decrease and chance of a complication in pregnancy increase as women get older (Martin 20). As a result, the trend of having children later has led to surrogacy becoming more common because they are unable to safely bear children at an older maternal age but still desire genetic similarity in their child.
Every nation in the world has their own policies in regards to surrogacy and who has the right to the child. Israel, for example, allows surrogacy on a case by case basis but does not allow homosexual couples to hire a surrogate (Tenman 80). Jewish-Israeli tradition celebrates reproduction as a woman’s mission. As a result, Israel encourages and even funds women to utilize technologically-assisted reproduction like in vitro fertilization(IVF), yet they believe surrogacy does not maintain the natural order. They believe it can allow infertile women to achieve their mission of motherhood, causing Israel to still debate the efficacy of surrogacy (Teman 81). A country like Norway, on the other hand, has outlawed surrogacy due to their strict laws on who can legally be the mother of the child. As a result, Norwegians have historically turned to a nation that like India when they desire surrogacy because until recently India contained commercial surrogacy agencies and a lack of strict laws regarding rights to the child (Deomampo 218).
The differing laws of each country often causes complications when surrogacy is crossing different nation’s borders. If a couple wants to have a child through surrogacy and it is not allowed or is very strict in their country, citizens often turn to another country to find a surrogate. This leads to miscommunications due to a language barrier and leaves couples in a country that is not their own with a baby that was born in that country. Establishing citizenship back in their home country is often difficult, especially in a country like Norway that defines a mother solely as someone who gives birth to the child, not just someone who has a genetic link to the child (Deomampo 221). One anthropologist studying the issue of surrogacy describes a situation where a couple traveled to India to pick up their child born via surrogate and they were stranded in India for weeks because their child was not yet considered theirs and a Norwegian citizen. They had to establish a genetic link through the father to get back to Norway and then the intended mother had to adopt her child. The mother was then still not considered a mother since she did not give birth to the child, so if her child became sick and had to go to the hospital she would not be given his health information (Deomampo 221). This example reveals that international surrogacy often becomes less viable when it crosses borders because the child is not born in the country the parents live so citizenship has to be established.
The main criticism of surrogacy is that it is disrupting nature and is a form of “baby selling” (O’ Reilly 1185). Gestational surrogates, where the surrogate mother does not use her own egg to get pregnant, often see their bodies as artificial and feel no connection with the child inside them. One surrogate mother in Israel stated, “The hormones do it all instead of me. My brain doesn’t even know that I am pregnant” (Teman 85). This is often criticized because it takes away a woman’s control in birthing and takes away any connection between surrogate mother and child in the womb. As one surrogate mother puts it, “It is kind of like we are fooling God!” (Tenman 89). Feminists argue that surrogacy allows wealthier families to exploit poorer women, calling it a form of “slavery” (Freidenfelds). Surrogacy and especially international surrogacy gains criticism because it is taking something women’s bodies should do naturally and turning it into a business that sometimes exploits vulnerable people (“Birthstory”). In addition, surrogacy can lead to complications as to who has the right to the baby. One Australian couple abandoned their baby with their Thai surrogate once they realized he had down syndrome even though he was their child legally in Thailand (Weerawang). With surrogacy crossing borders, couples cannot be as easily held accountable through the surrogacy process, leading to many political and ethical dilemmas.
Pictured is a surrogate mother with her 9-month old baby that was abandoned by the couple that hired the surrogate because the baby was born with Down syndrome, showing the perils of unregulated commercial surrogacy. (AP Photo/Apichart Weerawong)
Connection to Politics of Health
Surrogacy is often described as the medicalization of childbirth (Teman 81). Feminists critique the process because it makes something that was natural now unnatural and subject to medical control. Some feminists disagree with the medicalization of childbirth because it limits women’s control of birthing and alienates them from a potentially empowering experience (Teman 81). Surrogacy is an example of medicalization because it requires medical intervention in a woman’s body as compared to natural childbirth which can occur without any medical assistance (Conrad 3). This criticism of the medicalization of childbirth can also be linked to Metzl’s argument in “Why Against Health?” These feminists listed above are using the fact that surrogacy is not natural to condemn it, when it is women that cannot have children the “natural” way that have to turn to surrogacy. They are essentially passing judgement on both the surrogates and the couples hiring surrogates because they This is an example of, as Metzl puts it, of an aspect of health being filled with “value judgements, hierarchies, and blind assumptions that speak as much about power and privilege as they do about well-being” (Metzl 2).
Surrogacy also provides an example of a lack of informed consent. In one example, a homosexual Israeli couple agreed to have a surrogate in Nepal because they were told that the surrogate would receive significant financial compensation which would help the woman greatly and keep her family afloat. They were under the impression that the surrogacy was beneficial for the woman as well, but the couple later learned that the woman received less than half of what they were told she would. This was due to the fact that the contract listed the fees not as payment to the surrogate but as payment to “surrogacy services,” which included many other steps in the process like acquiring the eggs (“Birthstory”). This couple’s deep desire for a child made them vulnerable in the eyes of the surrogacy agency. They are an example of a ready-to-consent population because the surrogacy agency can get them to agree to something they might not necessarily agree with because they do not have another option since they are a gay couple in a nation that does not allow gay couples to hire surrogates (Fisher 195). The surrogacy agency took advantage of their vulnerability and did not allow them to give informed consent (Fisher 195).
Surrogacy also provides evidence of the racialization of health. Asian surrogacy companies use Asian women as surrogates but get women’s eggs from eastern Europe due to the desire of having “white eggs” (Deomampo 214). Most people seeking surrogates from Asia are from the United States, Canada or Europe and while they want an Asian woman to carry their child, they do not want their children to appear anything other than white (Deomampo 212). This ties into the desire for people to achieve “white” bodies because whiteness has become the standard most people desire (Wolf-Meyer 446). While it has been proven that races have very few genetic differences, having white skin is desired because parents want to have their child appear similar to them, even if only the father has the genetic link as is in the case of traditional surrogacy (“The Difference”).
References
“Birthstory.” Radiolab from WNYC, 22 Nov. 2015, www.radiolab.org/story/birthstory/.
Conrad, Peter. “The Shifting Engines of Medicalization.” Journal of Health and Social Behavior, vol. 46, no. 1, 2005, pp. 3–14. doi:10.1177/002214650504600102.
Deomampo, Daisy. “Defining Parents, Making Citizens: Nationality and Citizenship inTransnational Surrogacy.” Medical Anthropology, vol. 34, no. 3, 10 Mar. 2014, pp. 210–225. doi:10.1080/01459740.2014.890195.
Freidenfelds, Lara. “Surrogacy.” Encyclopedia of Children and Childhood: In History and Society, edited by Paula S. Fass, vol. 3, Macmillan Reference USA, 2004, pp. 801-802. Gale Virtual Reference Library, go.galegroup.com/ps/i.do?p=GVRL&sw=w&u=nash87800&v=2.1&id=GALE%7CCX3402800397&it=r&asid=56486b751edde3c93a559f7a1d28871c.
“Infertility Treatment Costs in the United States as of 2015 (in U.S. Dollars).” Statistica, ASRM, 2016.
Joyce, Allison. “India Surrogacy Ban.” AP Images, Associated Press, Anand, India, 18 Nov.2015, http://classic.apimages.com/fronts/Default.aspx?sh=14.
Markens, Susan. Surrogate Motherhood and the Politics of Reproduction. University ofCalifornia Press, 2007. EBSCOhost, proxy.library.vanderbilt.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=nlebk&AN=230009&site=ehost-live&scope=site.
Martin, Joyce A, et al. “Births: Final Data for 2015.” National Vital Statistic Reports, CDC, 5 Jan. 2017, www.cdc.gov/nchs/data/nvsr/nvsr66/nvsr66_01.pdf.
Metzl, Jonathan M. “Why Against Health?” How Health Became the New Morality , NYU Press, 2010, pp. 1–11.
O’Reilly, Andrea. Encyclopedia of Motherhood. SAGE Publications, Inc, 2010. EBSCOhost, proxy.library.vanderbilt.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=nlebk&AN=474287&site=ehost-live&scope=site.
“Surrogate motherhood.” Britannica Academic, Encyclopædia Britannica, 25 Jul. 2017. academic.eb.com/levels/collegiate/article/surrogate-motherhood/70470. Accessed 24 Sep. 2017.
Teman, Elly. “The Medicalization of ‘Nature’ in the ‘Artificial Body’: Surrogate Motherhood in Israel.” Medical Anthropology Quarterly, vol. 17, no. 1, 2003, pp. 78–98. doi:10.1525/maq.2003.17.1.78.
“The Difference Between Us: Race–The Power of an Illusion.” Vimeo, 13 Aug. 2014, vimeo.com/ondemand/race.
Weerawong, Apichart. “Thailand Business of Surrogacy.” AP Images, Associated Press, Sri Racha, Thailand, 07 Aug. 2014, http://classic.apimages.com/fronts/Default.aspx?sh=14.
Wolf-Meyer, Matthew. “Biomedicine, the Whiteness of Sleep, and the Wages of Spatiotemporal Normativity in the United States.” American Ethnologist, vol. 42, no. 3, 2015, pp. 446–458. doi:10.1111/amet.12140.
Additional
Agnafors, Marcus. “The Harm Argument against Surrogacy Revisited: Two Versions Not to Forget.” Medicine, Health Care and Philosophy, vol. 17, no. 3, 2014, pp. 357–363., doi:10.1007/s11019-014-9557-x.
Haberman, Clyde. “Baby M and the Question of Surrogate Motherhood.” The New York Times, The New York Times, 23 Mar. 2014, www.nytimes.com/2014/03/24/us/baby-m-and-the-question-of-surrogate-motherhood.html?mcubz=1.
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